Pilot offers physiotherapy in local gyms

Physiotherapy patients are being offered treatment in gyms and leisure centres in an innovative pilot which aims to make care more convenient by bringing it closer to home. 
 
Guy’s and St Thomas’ has partnered with ukactive, the UK’s trade body for the physical activity sector, to improve access to musculoskeletal rehabilitation and therapy services in the community. Around half of the team’s referrals are for patients suffering from lower back pain, for which regular exercise is key to recovery. The majority of other patients need to improve their fitness and muscle strength due to underlying conditions such as injuries, arthritis or fibromyalgia.
 
Across the 18-month pilot, around 25,000 patients are expected to benefit. The project combines the expertise of the Trust’s specialist staff with high-quality gym equipment at Castle Leisure Centre in Elephant and Castle, Brixton Recreation Centre and Streatham Ice and Leisure Centre. Patients are able to benefit from more space and a much wider range of equipment than at the hospital gym sites. These include mats, benches, steppers and cross trainers that can better support specific rehabilitation as well as general fitness, confidence and mental well-being. 
 
The initiative also lowers transport costs for patients and reduces travel time to and from appointments as they tend to be closer to their home or work. This helps make it easier to attend appointments and reduces health inequalities, with early data showing that the pilot has reduced ‘no shows’ by an average of 6 per cent. As an added bonus, patients are able to use the wider gym facilities - including pool, sauna and steam room facilities – for free on the days that they are attending physio services.
 
It is hoped that by accessing treatment in a local gym, patients will gain confidence in using equipment and possibly take up a membership – making them more likely to exercise regularly. Patients are able to access discounted gym memberships once their treatment finishes.
 

Dance teacher Samantha Babooram is among those who have benefited from the trial. She injured her knee whilst practicing a complicated dance move in December 2022. It got to a point where she could hardly walk, let alone dance. 
 
She originally took part in group sessions at Guy’s Hospital, but found the one-to-one sessions she received in the summer at Castle Leisure Centre far more productive as she was able to lift weights and do plyometrics, a type of exercise training that uses speed and force of different movements to build muscle power. The gym was also more convenient for her to get to from her part-time job as a dance teacher and choreographer at a school in Baker Street.
 
Samantha, 38, said: “The sessions changed my life. When you go to the hospital, there’s only so much you can do whereas the gym was amazing as it’s really easy to progress. 
 
“They were very kind and supportive when I was freaking out that my progression was up and down. They really tailored the exercises to my goals which included being able to spin and dancing in heels again!”
 
Samantha, who lives in North Woolwich, has been going to a gym near her house but is considering joining Castle Leisure Centre as the facilities are better. Now that her injury has dramatically improved, she hopes to launch her own dance party business. 
 
Shifting to local gyms has also meant it is possible for the physio team to see up to 3 patients at a time, reducing wait times and adding a social element which studies show can improve attendance, motivation and patient experience. 
 

Nursery teacher Zina Georgieva took part in the group back rehab classes at Castle Leisure Centre after injuring herself at work. The convenient location meant she was able to travel to the sessions in just 10 minutes. 
 
Zina, 31, said: “I didn’t know what to expect from the classes but they were the best thing I have ever done - really supportive and helpful. It wasn’t just about doing the exercises, there was an element of mental health support too as you also got to speak to other people who knew how you were feeling.”
 
Castle Leisure Centre was the first location to become available in February 2023. Attendance quadrupled in the first month, with an average of 150 to 200 patients now seen weekly. Brixton Recreation Centre was chosen as one of the additional locations as it offers women only gym sessions, which was listed as being important to some patients in a pre-pilot survey.
 
The pilot has been made possible thanks to funding from the Guy’s & St Thomas’ Charity. 
 
Jenny Heal, project lead and clinical lead musculoskeletal physiotherapist, said: “We know that there are significant barriers to some patients accessing our services, from the stigma attached to accessing specialist healthcare units to those who are physically unable to travel to central London sites. 
 
“I also think it’s very important to empower patients to be responsible for their own health. By making it easier for them to access physiotherapy close to home, we are providing support which should lead to a better quality of life, as well as a reduced burden on the NHS. We really hope this initiative can be rolled out more widely across the Trust.” 
 
ukactive has helped to establish the pilot by working with the Trust to design and deliver the initiative, working with operators from its membership.
 
Huw Edwards, CEO of ukactive, said: “Our partnership with Guy's and St Thomas’ is a clear example of how the physical activity sector is stepping up to support the NHS and the major health conditions which impact our nation’s health and cause pain for millions of people.
 
“We know musculoskeletal conditions cause the third largest spend for the NHS and with such increasing pressure on the health service, our sector is providing accessible facilities and equipment to help patients get the therapy they need to live long, healthy and more active lives.
 
“Gyms and leisure facilities are key community hubs across the UK and we’re looking forward to supporting Guy’s and St Thomas’ to continue this project as well as working with other NHS Trusts to help scale this model and reach many more patients.”